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采用慢性肾脏病流行病学协作组(CKD-EPI)方程对中国老年患者肾功能及危险因素进行回顾性分析。

A retrospective analysis of kidney function and risk factors by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation in elderly Chinese patients.

作者信息

Liu Wei, Yu Feng, Wu Yanhua, Fang Xiaowu, Hu Wenxue, Chen Jian, Zhou Ruili, Lin Xinge, Hao Wenke

机构信息

a Department of Nephrology , Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Geriatric Institute , Guangzhou , China .

b Department of Cardiology , Guangdong General Hospital, Guangdong Academy of Medical Sciences , Guangzhou , China .

出版信息

Ren Fail. 2015;37(8):1323-8. doi: 10.3109/0886022X.2015.1068513. Epub 2015 Jul 27.

Abstract

Chronic kidney disease accounts for much of the increased mortality, especially in the elder population. The prevalence of this disease is expected to increase significantly as the society ages. Our aim was to evaluate the kidney function and risk factors of reduced renal function among elderly Chinese patients. This study retrospectively collected clinical data from a total of 1062 inpatients aged 65 years or over. Estimated glomerular filtration rate (eGFR) was calculated with the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Renal function and risk factors were also analyzed. For all 1062 subjects, the mean eGFR was 71.0 ± 24.8 mL/min/1.73 m(2), and the incidence rates of reduced renal function, proteinuria, hematuria and leukocyturia were 31.1%, 11.8%, 6.6% and 8.7%, respectively. The eGFR values were 83.4 ± 28.4, 72.2 ± 22.9, 67.8 ± 24.3 and 58.8 ± 29.1 mL/min/1.73 m(2) in the groups of 60-69, 70-79, 80-89 and ≥90 years age group (F = 15.101, p = 0.000), respectively; while the incidences of reduced renal function were 12.8%, 27.0%, 37.8% and 51.7% (χ(2) = 36.143, p = 0.000). Binary logistic regression analysis showed that hyperuricemia (OR = 4.62, p = 0.000), proteinuria (OR = 3.96, p = 0.000), urinary tumor (OR = 2.92, p = 0.015), anemia (OR = 2.45, p = 0.000), stroke (OR = 1.96, p = 0.000), hypertension (OR = 1.83, p = 0.006), renal cyst (OR = 1.64, p = 0.018), female (OR = 1.54, p = 0.015), coronary artery disease (OR = 1.53, p = 0.008) and age (OR = 1.05, p = 0.000) were the risk factors of reduced renal function. In conclusion, eGFR values decreased by age, while the incidence of reduced renal function, proteinuria, hematuria and leukocyturia increased with age. Treatment and control of comorbidities may slow the decline of renal function in elderly patients.

摘要

慢性肾脏病是死亡率上升的主要原因之一,尤其在老年人群中。随着社会老龄化,这种疾病的患病率预计将显著增加。我们的目的是评估中国老年患者的肾功能及肾功能减退的危险因素。本研究回顾性收集了1062例65岁及以上住院患者的临床资料。采用慢性肾脏病流行病学合作组(CKD-EPI)公式计算估算肾小球滤过率(eGFR)。同时分析肾功能及危险因素。1062例受试者的平均eGFR为71.0±24.8 mL/min/1.73m²,肾功能减退、蛋白尿、血尿和白细胞尿的发生率分别为31.1%、11.8%、6.6%和8.7%。60-69岁、70-79岁、80-89岁和≥90岁年龄组的eGFR值分别为83.4±28.4、72.2±22.9、67.8±24.3和58.8±29.1 mL/min/1.73m²(F=15.101,p=0.000);而肾功能减退的发生率分别为12.8%、27.0%、37.8%和51.7%(χ²=36.143,p=0.000)。二元logistic回归分析显示,高尿酸血症(OR=4.62,p=0.000)、蛋白尿(OR=3.96,p=0.000)、泌尿系统肿瘤(OR=2.92,p=0.015)、贫血(OR=2.45,p=0.000)、中风(OR=1.96,p=0.000)、高血压(OR=1.83,p=0.006)、肾囊肿(OR=1.64,p=0.018)、女性(OR=1.54,p=0.015)、冠状动脉疾病(OR=1.53,p=0.008)和年龄(OR=1.05,p=0.000)是肾功能减退的危险因素。总之,eGFR值随年龄增长而降低,而肾功能减退、蛋白尿、血尿和白细胞尿的发生率随年龄增长而增加。治疗和控制合并症可能会减缓老年患者肾功能的下降。

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